By Dr. Tilak S. Fernando

Is it Kuveni’s centuries-old curse still affecting our nation that it makes impossible to get the simplest form of a job done out of a Government office? Lassitude is different from that of inefficiency, but if politically placed square pegs in round holes are up to monkey pranks, it becomes a travesty, and begins to drive the nation in reverse gear on roller coasters.

The following is a self-explanatory example of how the wildlife in Sri Lanka has been playing games with an international institution, despite the President and Prime Minister approving of a project, which could save life and bring millions of foreign exchange into the country.

AVRI and University of Peradeniya Medical School

Animal Venom Research International (AVRI) is an organization with the vision of alleviating human suffering caused by the bites of venomous animals by developing safe and effective anti -venoms. Statistics reveal over 100,000 deaths occur annually due to snakebites, and more than 400,000 people having to amputate their limbs or “rendered useless“, after being bitten by cobras, vipers and other venomous snakes, suffer debilitating injuries throughout the world.

Sri Lanka records one of the highest per capita envenomation rates due to snakebites, with 105 species, and a recorded number of 80,000 people bitten by snakes in 2010 alone has made Sri Lanka a nation of special concern. Currently, Sri Lanka depends on large doses of imported anti-venom of impure quality causing adverse reactions in patients. Sri Lanka Government spends approx. US$1 million on anti-venoms, with hospital costs exceeding US$10 million per annum.

National Survey

As epidemiological data on snakebite statistics available in hospitals are limited, a national survey led by Dileepa Senajith Ediriweera and his team of experts had researched in nine provinces of Sri Lanka to arrive at meaningful statistics. Snakebite is a neglected tropical disease. “The doctors treating snakebite and envenoming in Sri Lanka require a low reactogenic, cheap, and an effective polyvalent anti-venom serum. Until such time, the currently available imported anti-venom from India has to be used”. (The Medical Journal of Ceylon 2002).

In the wake of such a dilemma, the President and the Minister of Health invited AVRI to Sri Lanka and gave the go-ahead to develop species-specific anti-venom by setting up of a manufacturing plant. The Anti-venom imported from India is of poor quality and the reaction rate has been in the region of 70-80%, due to pyrogens in the vials.

The Economic Management Committee of Sri Lanka authorized the new project in 2006 to produce polyspecific anti-venom for Sri Lanka. AVRI collaborated with the Medical School, Peradeniya, and funded the project. In the meantime, the Ministry of Health, BOI Sri Lanka and the Officials in the Committee of the Economic Management approved the project on 20 January 2017, at the Prime Minister’s Office, which instructed the Director, Department of Wild Life, Sri Lanka, to provide the necessary approvals etc.

Kick-Start

With such a kick-start, the primary large-scale learning facility for venom research in Sri Lanka was established by AVRI, along with the University of Peradeniya and a team of skilled veterinarians from the USA, who trained Sri Lankans to handle, treat and extract venom from snakes, without killing a single snake, and educating the locals that snakes too are part of the eco system, and their bites are treatable with the locally-produced ‘species specific’ anti-venom.

According to estimates, people kill over 1,000 snakes every week. Prof. Sarath Kotagama, a former Director General of wildlife, once had questioned the Department of Wildlife whether the DWC is committed towards prevention of people killing snakes, and also are they blind to the prevailing social and economic costs to the Nation resulting from snakebites. He further stressed that we must save people and snakes.”

Ignorance at the DWC

Laki Wickremesinghe, Chairman (AVRI Sri Lanka) states that “the level of ignorance of the Officials in the Department of Wildlife is unbelievable, and they treat University Professors from the Medical Faculty and the Vice Chancellor, like schoolchildren“. One is hesitant to conclude whether the officials are corrupt and are acceding to the wishes of the masters in India!

Despite such frustrating hiccups, the project is worthy in any part of the world where a problem with venomous snakes exists, and the study of technical aspects of venom is warranted. In this regard, one must blame Wildlife official’s callous disregard towards the victims of snakebite. At no stage they (DWC) have enquired from Prof. Gawarammana how the DWC could help. The Minister of Wildlife has full authority, under the Wildlife Act, to remedy any situation, and not heel with the ignorance of the Department but to permit collection of the deadly snake species

Sri Lankan-born Herpetologist and the US-based Executive Director of AVRI, Roy Malleappah, and his team have produced the latest (Sri Lankan) anti-venom (ICP-AVRI), which is poly-specific, against the most common type of venomous Sri Lankan snake, the hump-nosed pit viper for the first time in the world. So far, the Instituto Clodomiro Picado (ICP) in Costa Rica has developed anti-venom, and with the latest invention of Freeze-dried EchiTAb+ICP- Avri Sri Lanka, which has a neutralizing effective rate of 3.50 (2.54-6.50) on Hypnale, in comparison with anti-venom currently used in Sri Lanka (VINS), with only 0.58 (0.26-0.86).

Frustrations

One could imagine the amount of frustration AVRI must have endured, for thirteen long years, facing hindrances and disappointments, even after the project initiated in 2006, it has been hampered by the cussed attitudes of top officials in the Wildlife, either due to their inefficiency or simply because of the fact that few palms have been “oiled” by the Indian exporters!

On 5 February 2017, Director, AVRI wrote to the Director General DWC, referring to his earlier correspondence pointing out serious factual errors in his letter, and the fact that “People were dying in Sri Lanka without a species-specific anti-venom, and emphasizing that the Indian anti-venom is not effective according to many medical experts who treat snake envenomed patients. Stressing further, he added that Sri Lanka Agents of the Indian Manufacturer were attempting to export venom in large quantities to India, the same agents who “facilitate the import of poor quality and ineffective anti-venom, which has been going on for over 65 years.”

Disappointed Professor

On 20 December 2017, Prof. Indika Gawarammana wrote to the Chairman National Research Council, regarding the on-going difficulties with regard to the Anti-venom Project, highlighting the facts. He appears to be more perturbed by the fact that all his genuine efforts are taken as if he was expecting a personal favour from DWC, and the worse being that he was made to believe such a situation as the lowest, an academic is made to feel. What the Professor needed was permission to export a small quantity of venom of Bungarus Caerulevs to Costa Rica to incorporate into the Polyvalent anti-venom, which they have already produced, and to seek the clearance for a list of volunteers to collect snakes.

All such dilly-dallying has made AVRI to postpone the importation of horses (used for anti-venom production) after purchasing lands in Matale and in Peradeniya for this purpose. The National Research Council has also invested a large sum of public money in the development of these anti-venoms.

Wickremesinghe referring to ‘negative criticism of investing in Sri Lanka’ by Bloomberg Group reiterated that ‘Lankan Professionals, need to hold Sri Lankan State Institutions to higher standards, which they are capable of, to respond to the negative perception in the world that Sri Lanka is at the very bottom of investment tables”. Victims and their relatives might find solutions as the “SAITM” style.

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